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Pulse Oximetry: A Non-Invasive, Novel Marker for the Quality of Chest Compressions in Porcine Models of Cardiac Arrest.

Xu J, Li C, Zheng L, Han F, Li Y, Walline J, Fu Y, Yao D, Zhang X, Zhang H, Zhu H, Guo S, Wang Z, Yu X - PLoS ONE (2015)

Bottom Line: The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.The frequency of POP closely matched the CPR heart rate.AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

View Article: PubMed Central - PubMed

Affiliation: Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.

ABSTRACT

Objective: Pulse oximetry, which noninvasively detects the blood flow of peripheral tissue, has achieved widespread clinical use. We have noticed that the better the quality of cardiopulmonary resuscitation (CPR), the better the appearance of pulse oximetry plethysmographic waveform (POP). We investigated whether the area under the curve (AUC) and/or the amplitude (Amp) of POP could be used to monitor the quality of CPR.

Design: Prospective, randomized controlled study.

Setting: Animal experimental center in Peking Union Medical Collage Hospital, Beijing, China.

Subjects: Healthy 3-month-old male domestic swine.

Interventions: 34 local pigs were enrolled in this study. After 4 minutes of untreated ventricular fibrillation, animals were randomly assigned into two resuscitation groups: a "low quality" group (with a compression depth of 3cm) and a "high quality" group (with a depth of 5cm). All treatments between the two groups were identical except for the depth of chest compressions. Hemodynamic parameters [coronary perfusion pressure (CPP), partial pressure of end-tidal carbon dioxide (PETCO2)] as well as AUC and Amp of POP were all collected and analyzed.

Measurements and findings: There were statistical differences between the "high quality" group and the "low quality" group in AUC, Amp, CPP and PETCO2 during CPR (P<0.05). AUC, Amp and CPP were positively correlated with PETCO2, respectively (P<0.01). There was no statistical difference between the heart rate calculated according to the POP (FCPR) and the frequency of mechanical CPR at the 3rd minute of CPR. The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.

Conclusions: Both the AUC and Amp of POP correlated well with CPP and PETCO2 in animal models. The frequency of POP closely matched the CPR heart rate. AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

No MeSH data available.


Related in: MedlinePlus

A. The correlation between AUC and CPP during different stages of CPR a. AUC was not correlated with CPP at the 3rd minute of CPR (r = 0.348, P = 0.047). b. At the 6th minute of CPR, AUC was not correlated with CPP (r = 0.281, P = 0.114). c. A correlation couldn’t be detected between AUC and CPP at the 9th minute of CPR (r = 0.396, P = 0.023). B. The correlation between Amp and CPP during different stages of CPR a. Amp was positively correlated with CPP at the 3rd minute of CPR (r = 0.450, P = 0.009). b. At the 6th minute of CPR, Amp was not correlated with CPP (r = 0.378, P = 0.030). c. A positive correlation could be detected between Amp and CPP at the 9th minute of CPR (r = 0.441, P = 0.010). C. The correlation between PETCO2 and CPP during different stages of CPR a. PETCO2 was positively correlated with CPP at the 3rd minute of CPR (r = 0.543, P = 0.001). b. At the 6th minute of CPR, PETCO2 was not correlated with CPP (r = 0.429, P = 0.013). c. PETCO2 was positively correlated with CPP at the 9th minute of CPR (r = 0.728, P<0.001).
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pone.0139707.g003: A. The correlation between AUC and CPP during different stages of CPR a. AUC was not correlated with CPP at the 3rd minute of CPR (r = 0.348, P = 0.047). b. At the 6th minute of CPR, AUC was not correlated with CPP (r = 0.281, P = 0.114). c. A correlation couldn’t be detected between AUC and CPP at the 9th minute of CPR (r = 0.396, P = 0.023). B. The correlation between Amp and CPP during different stages of CPR a. Amp was positively correlated with CPP at the 3rd minute of CPR (r = 0.450, P = 0.009). b. At the 6th minute of CPR, Amp was not correlated with CPP (r = 0.378, P = 0.030). c. A positive correlation could be detected between Amp and CPP at the 9th minute of CPR (r = 0.441, P = 0.010). C. The correlation between PETCO2 and CPP during different stages of CPR a. PETCO2 was positively correlated with CPP at the 3rd minute of CPR (r = 0.543, P = 0.001). b. At the 6th minute of CPR, PETCO2 was not correlated with CPP (r = 0.429, P = 0.013). c. PETCO2 was positively correlated with CPP at the 9th minute of CPR (r = 0.728, P<0.001).

Mentions: AUC was not correlated with CPP in this study (r = 0.348, 0.281 and 0.396, P = 0.047, 0.114, and 0.023 at the 3rd, 6th and 9th minute respectively) (Fig 3A). Amp was positively correlated with CPP at the 3rd minute (r = 0.450, P = 0.009) but no correlation was detected at the 6th minute (r = 0.378, P = 0.030) and 9th minute (r = 0.441, P = 0.010) (Fig 3B). CPP was positively correlated with PETCO2 at the 3th minute (r = 0.543, P = 0.001) and 9th minute (r = 0.728, P<0.001), but no correlation was detected at the 6rd minute (r = 0.429, P = 0.013) (Fig 3C). There was positive correlation between AUC and PETCO2 (r = 0.725, 0.648, and 0.644 at the 3rd, 6th and 9th minute respectively, P<0.001) (Fig 4A), the same between Amp and PETCO2 (r = 0.529, 0.493 and 0.480, P = 0.002, 0.004, and 0.005 at the 3rd, 6th and 9th minute respectively) (Fig 4B).


Pulse Oximetry: A Non-Invasive, Novel Marker for the Quality of Chest Compressions in Porcine Models of Cardiac Arrest.

Xu J, Li C, Zheng L, Han F, Li Y, Walline J, Fu Y, Yao D, Zhang X, Zhang H, Zhu H, Guo S, Wang Z, Yu X - PLoS ONE (2015)

A. The correlation between AUC and CPP during different stages of CPR a. AUC was not correlated with CPP at the 3rd minute of CPR (r = 0.348, P = 0.047). b. At the 6th minute of CPR, AUC was not correlated with CPP (r = 0.281, P = 0.114). c. A correlation couldn’t be detected between AUC and CPP at the 9th minute of CPR (r = 0.396, P = 0.023). B. The correlation between Amp and CPP during different stages of CPR a. Amp was positively correlated with CPP at the 3rd minute of CPR (r = 0.450, P = 0.009). b. At the 6th minute of CPR, Amp was not correlated with CPP (r = 0.378, P = 0.030). c. A positive correlation could be detected between Amp and CPP at the 9th minute of CPR (r = 0.441, P = 0.010). C. The correlation between PETCO2 and CPP during different stages of CPR a. PETCO2 was positively correlated with CPP at the 3rd minute of CPR (r = 0.543, P = 0.001). b. At the 6th minute of CPR, PETCO2 was not correlated with CPP (r = 0.429, P = 0.013). c. PETCO2 was positively correlated with CPP at the 9th minute of CPR (r = 0.728, P<0.001).
© Copyright Policy
Related In: Results  -  Collection

License
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getmorefigures.php?uid=PMC4613139&req=5

pone.0139707.g003: A. The correlation between AUC and CPP during different stages of CPR a. AUC was not correlated with CPP at the 3rd minute of CPR (r = 0.348, P = 0.047). b. At the 6th minute of CPR, AUC was not correlated with CPP (r = 0.281, P = 0.114). c. A correlation couldn’t be detected between AUC and CPP at the 9th minute of CPR (r = 0.396, P = 0.023). B. The correlation between Amp and CPP during different stages of CPR a. Amp was positively correlated with CPP at the 3rd minute of CPR (r = 0.450, P = 0.009). b. At the 6th minute of CPR, Amp was not correlated with CPP (r = 0.378, P = 0.030). c. A positive correlation could be detected between Amp and CPP at the 9th minute of CPR (r = 0.441, P = 0.010). C. The correlation between PETCO2 and CPP during different stages of CPR a. PETCO2 was positively correlated with CPP at the 3rd minute of CPR (r = 0.543, P = 0.001). b. At the 6th minute of CPR, PETCO2 was not correlated with CPP (r = 0.429, P = 0.013). c. PETCO2 was positively correlated with CPP at the 9th minute of CPR (r = 0.728, P<0.001).
Mentions: AUC was not correlated with CPP in this study (r = 0.348, 0.281 and 0.396, P = 0.047, 0.114, and 0.023 at the 3rd, 6th and 9th minute respectively) (Fig 3A). Amp was positively correlated with CPP at the 3rd minute (r = 0.450, P = 0.009) but no correlation was detected at the 6th minute (r = 0.378, P = 0.030) and 9th minute (r = 0.441, P = 0.010) (Fig 3B). CPP was positively correlated with PETCO2 at the 3th minute (r = 0.543, P = 0.001) and 9th minute (r = 0.728, P<0.001), but no correlation was detected at the 6rd minute (r = 0.429, P = 0.013) (Fig 3C). There was positive correlation between AUC and PETCO2 (r = 0.725, 0.648, and 0.644 at the 3rd, 6th and 9th minute respectively, P<0.001) (Fig 4A), the same between Amp and PETCO2 (r = 0.529, 0.493 and 0.480, P = 0.002, 0.004, and 0.005 at the 3rd, 6th and 9th minute respectively) (Fig 4B).

Bottom Line: The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.The frequency of POP closely matched the CPR heart rate.AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

View Article: PubMed Central - PubMed

Affiliation: Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical sciences, Beijing, China.

ABSTRACT

Objective: Pulse oximetry, which noninvasively detects the blood flow of peripheral tissue, has achieved widespread clinical use. We have noticed that the better the quality of cardiopulmonary resuscitation (CPR), the better the appearance of pulse oximetry plethysmographic waveform (POP). We investigated whether the area under the curve (AUC) and/or the amplitude (Amp) of POP could be used to monitor the quality of CPR.

Design: Prospective, randomized controlled study.

Setting: Animal experimental center in Peking Union Medical Collage Hospital, Beijing, China.

Subjects: Healthy 3-month-old male domestic swine.

Interventions: 34 local pigs were enrolled in this study. After 4 minutes of untreated ventricular fibrillation, animals were randomly assigned into two resuscitation groups: a "low quality" group (with a compression depth of 3cm) and a "high quality" group (with a depth of 5cm). All treatments between the two groups were identical except for the depth of chest compressions. Hemodynamic parameters [coronary perfusion pressure (CPP), partial pressure of end-tidal carbon dioxide (PETCO2)] as well as AUC and Amp of POP were all collected and analyzed.

Measurements and findings: There were statistical differences between the "high quality" group and the "low quality" group in AUC, Amp, CPP and PETCO2 during CPR (P<0.05). AUC, Amp and CPP were positively correlated with PETCO2, respectively (P<0.01). There was no statistical difference between the heart rate calculated according to the POP (FCPR) and the frequency of mechanical CPR at the 3rd minute of CPR. The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.

Conclusions: Both the AUC and Amp of POP correlated well with CPP and PETCO2 in animal models. The frequency of POP closely matched the CPR heart rate. AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

No MeSH data available.


Related in: MedlinePlus